伴有乳头溢液乳腺癌与导管内乳头状瘤的乳腺导管造影诊断

摘要

目的：总结分析伴有乳头溢液乳腺癌以及导管内乳头状瘤的乳腺导管造影X线表现，评价两者的诊断与鉴别诊断价值。方法：回顾性分析经手术和病理证实的23例乳腺癌和36例乳腺导管内乳头状瘤患者的乳腺导管造影检查影像资料。结果：乳腺癌导管造影主要表现为分支导管内不规则的充盈缺损伴导管壁破坏、导管阻塞中断、“潭湖征”等较为典型的征象；导管内乳头状瘤的导管造影主要表现为大导管内光整的充盈缺损，导管壁多无破坏，并伴有导管扩张以及导管扭曲。乳腺瘤与乳头状瘤在充盈缺损、导管壁破坏、导管完全中断、导管扩张以及“潭湖征”等X线征象上差异有统计学意义（P＜0．05）。乳腺导管造影诊断伴有乳头溢液乳腺癌和乳头状瘤的符合率分别为78．3％和80．1％。结论：不规则的充盈缺损伴导管壁破坏、导管阻塞中断、“潭湖征”等征象及发生部位上乳腺癌和乳腺导管内乳头状瘤两者各有特点，是诊断和鉴别诊断的重点。%Obj ective:To analyze the galactographic features in breast cancer with nipple discharge and intraductal papilloma,and to assess their diagnostic value and differential diagnostic value.Methods:A retrospective study was per-formed to analyze the galactographic features of 23 surgically and pathologically proved breast cancer and intraductal papil-loma during September 2006 to November 2011.Results:Galactographic features of breast cancer:There were irregular in-traductal filling defects with ductal wall destruction and ductal obstruction in the peripheral ducts.Galactographic features of intraductal papilloma:there were smooth intraductal filling defects without wall destruction of the main duct,and ductal dilatation and torsion.Conclusion:The above mentioned differences in galactographic patterns such as location and changes of duct wall and lumen,in breast cancer and intraductal papilloma have their own characteristics which serves as the key to the diagnosis and differential diagnosis.